Provider Demographics
NPI:1013966225
Name:GOCKE, JAMES M (FNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:GOCKE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 COUNTY RD STE E
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-4462
Mailing Address - Country:US
Mailing Address - Phone:775-392-0853
Mailing Address - Fax:775-392-0878
Practice Address - Street 1:1700 COUNTY RD STE E
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4462
Practice Address - Country:US
Practice Address - Phone:775-392-0853
Practice Address - Fax:775-392-0878
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA429409363LP2300X
NV002605363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
S59433Medicare UPIN
CAWNP7894AMedicare ID - Type Unspecified